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Quadros et al., Vitam Miner 2016, 5:1

Vitamins & Minerals

http://dx.doi.org/10.4172/2376-1318.1000136
a

als
Vit

ISSN: 2376-1318

Mini Review Open Access

Ascorbic Acid and Performance: A Review

Luciana de Quadros, Igor Brandao2 and Rafael Longhi3*
Nutricionist, Pos Graduate in Sports Nutrition, Brazil
2
University Center AGES - UniAges, Center of Health and Biological Sciences, Federal University of Sergipe (UFS), Brazil
3
Department of Biochemistry, Postgraduate Program in Biochemistry, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Brazil

Abstract
Purpose: Review of the evidence which supports the consumption of vitamin C for sportsmen and athletes aiming
improvement performance. Data synthesis: Vitamin C is an essential micronutrient with several important biological
functions. In addition to being considered a potent antioxidant that eliminates reactive oxygen and nitrogen species.
Among other functions, vitamin C reduces the symptoms of colds and flu, accelerating the recovery process and has
an anti-catabolic effect. This effect has fundamental importance for the physically active. Considering that vitamin C
participates as a cofactor in carnitine biosynthesis, steroid hormones and neurotransmitters, it has been established
the idea that the need for this nutrient would increase for people engaged in strenuous exercise or frequent stress.
Because of this, this paper aims to investigate the role of this micronutrient in performance.
Material and methods: We searched the published scientific literature for randomized controlled trials of adult
human subjects reporting vitamin C intake and training, besides animal models and literature review about the topic.
Twenty-eight papers since 2000 were identified by searches of PubMed, with the search terms ascorbic acid,
bioavailability, oxidative stress, performance, free radicals supplementation, toxicity and vitamin C, ensuring
recent knowledge about ascorbic acid.
Conclusions: The importance of vitamin C in the diet is indisputable, but more research is needed to clarify
whether supplementation of this micronutrient actually leads to performance optimization.

Keywords: Vitamin C; Bioavailability; Oxidative
Supplementation; Toxicity
Introduction
Regular physical activity associated with a balanced diet can be
an important factor in health promotion. However, frequent high
intensity or exhaustive exercises can increase susceptibility to injury,
promote chronic fatigue and overtraining, partially due to the high
synthesis of reactive oxygen species [1].
The search for improvement in the performance of athletes and
sportsmen has been discussed in order to find nutrients that optimize
the results without causing toxicity to the consumer. Vitamin C is an
essential micronutrient with many important biological functions, and
a cofactor for the biosynthesis of collagen, carnitine, neurotransmitters,
peptide hormones and has an anti-catabolic effect and also accelerates
muscle recovery [2,3].
A high vitamin C food sources diet is based on citrus/acid fruits or
their juices (cherry, orange, pineapple, cashew, guava, mango, passion
fruit, lemon), berries, green and red peppers, tomatoes, broccoli and
leafy vegetables such as spinach [4]. The recommendation of vitamin
C is easily achieved since we consume at least one of its food source
daily. The RDAs of vitamin C are from 90 mg to 75 mg for men and
women, respectively. The absorption of vitamin C is about 70% to 90%
of the ingested intake when the amount is in the range of 30 to 180 mg
/ day. However, when the amount is around 1 g absorption is reduced
by 50% [5].
The latest recommendations of vitamin C, according to the
National Academy of Sciences, are 75 mg for men and 90 mg for men,
and smokers may require 35 mg extras, the maximal daily tolerated
intake is 2,000 mg [4]. Deruelle and Baron (2008), reports that the
recommended daily allowance (RDA) for vitamin C is smaller than the
body needs. In fact, it does not seem to guarantee the protection of true
health and it seems to be difficult to achieve an effective dose of vitamin
C only through the consumption of food [6].
According to Gomes et al. vitamin C is also a strong reducing agent,
stress; due to its easiness of donating electrons, with important antioxidant
properties. It can inactivate a wide variety of reactive species minimize
damage to body tissues [7]. Vitamin C, among other effects, reduces
the symptoms of colds and flu, accelerating the process of recovery and
has an anti-catabolic effect. This anti-catabolic effect is essential for
bodybuilders [3].
Antioxidant action and physical activity
Ascorbic acid is considered a potent antioxidant, which eliminates
reactive oxygen and nitrogen [8]. Antioxidants are substances which
contribute to reduce the effects of stress and lack of oxygen caused
by exercise, forming complexes which reduce free radical producing
reactions. Free radicals are unstable molecules, without a pair of
electrons in their outer orbits and are highly reactive and can cause
traumatic processes in the tissues caused by different reactions. Intense
and continuous physical exercise produces free radicals, which can
cause muscle damage followed by the inflammatory process, restricting
muscle function [9].
Experimental studies suggest an important role of oxidative stress
in atherogenesis: damage mediated by free radicals inducing oxidative
changes in low-density cholesterol particles that initiate and promote
atherosclerotic changes. This process can be reversed or prevented
by the intake of antioxidants [10]. Considering that ascorbic acid
participates as a cofactor in carnitine biosynthesis, steroid hormones
and neurotransmitters, it was established the idea that the requirements
*Corresponding author: Dr. Rafael Longhi, Department of Biochemistry,
Postgraduate Program in Biochemistry, Institute of Basic Health Sciences, Federal
University of Rio Grande do Sul (UFRGS), Brazil, Tel: 555192943921; E-mail:
longhinutricao@gmail.com
Received February 14, 2016; Accepted March 04, 2016; Published March 11, 2016
Citation: Quadros L, Brandao I, Longhi R (2016) Ascorbic Acid and Performance:
A Review. Vitam Miner 5: 136. doi:10.4172/2376-1318.1000136
Copyright: 2016 Quadros L, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited.

Vitam Miner Volume 5 Issue 1 1000136

ISSN: 2376-1318 VMS, an open access journal
Citation: Quadros L, Brandao I, Longhi R (2016) Ascorbic Acid and Performance: A Review. Vitam Miner 5: 136. doi:10.4172/2376-1318.1000136
of this nutrient would be increased among people engaged in strenuous
exercise or frequent stress. But it seems that there is no evidence to
support this hypothesis [5].
The reasons of the increased production of free radicals during
exercise have not been fully clarified. Although several mechanisms
have been identified, there remains a lack of understanding on how
each of them contributes to the total quantity of oxidative stress
produced. For example, although the general consensus is that, during
exercise, the production of reactive species occurs mainly through the
muscle contraction (skeletal and cardiac), other mechanisms such as
inflammation and increased release of catecholamines which can occur
with exercise also play an important role in the generation of reactive
species [7].
Regarding the intense exercise, both aerobic and anaerobic exercise
can result in increased production of free radicals, but the acute
oxidative stress cannot always be evaluated by athletes. The production
of reactive oxygen species is positively dependent on the load (intensity
duration) of the exercise. It is suggested that high reactive oxygen
species produced by intense series of exercise can be harmful to the
immune system. However, chronic exercise produces physiological
adaptations capable of regulating the antioxidant system [7].
Important to highlight that vitamin C controls the production of
cortisol. It is a hormone released during stress conditions and/or high
physical efforts are conducted, as a heavy training, this hormone is an
antagonist to testosterone, in fact, the release of cortisol suppresses
the natural testosterone produced in our body, then it begins a
dispute between these two hormones; while there is a catabolic
effect of cortisol, there is an anabolic effect of testosterone [3]. Peter
et al. proposed that vitamin C-associated decrease in serum cortisol
might result from inhibition of enzymes involved in steroidogenesis,
in their paper were evaluated 29 runners and the results showed
serum cortisol was significantly lower in the vitamin C group [11].
Corroborating, Padayatty et al. in their research comment that the
essential adrenocorticotrophic hormone (ACTH) secreted by the
pituitary gland stimulates adrenal glands to synthesize and secrete
cortisol. In animals, ACTH also causes vitamin C loss from adrenals.
Adrenal glands are rich in vitamin C, with concentrations as high as 10
mmol/L, for these reasons, vitamin C and stress in humans have long
been associated, despite a lack of direct evidence for such a link [12].
According the available literature there are some different results in
relation to oxidative stress rates as the result of exercise performance.
This is understandable, because a variety of factors can influence the
oxidative rate, such as hired muscle groups, the contraction modes,
exercise intensity, exercise duration, and the population exercising [7].
Effect of antioxidant supplementation
The literature shows that the highest intake of vitamin C than the
RDA is safe. Therefore, in order to gain health and preventing a number
of diseases, it is suggested that, in this situation, the supplemental
vitamin C is required, in order to ensure optimal allowance of vitamin
C, it is advisable 1 g daily vitamin C supplementation, accompanied
by a diet with fruits and vegetables [6]. On the other hands, Palmer et
al. found that supplementation with 1,500 mg vitamin C/day for seven
days before and during an ultra-marathon did not attenuate oxidative
stress after the race [13]. There is a lack of direct evidence ensuring
that vitamin C is beneficial to performance, and there is no convincing
evidence to suggest that antioxidant supplementation enhances
exercise-training adaptations, which is an important factor to avoid
supplementation in high dosage [14].
Vitam Miner
ISSN: 2376-1318 VMS, an open access journal
Page 2 of 4
A study determined the effects of four weeks vitamin C
supplementation (1000 mg /day), daily throughout the training period,
in the performance of moderately trained humans (7 men in the
placebo group aged 23 years and 8 males men in the supplemented
group aged 21 years), in an interval race protocol of high intensity
lasting four weeks was implemented. The training improved both VO2
max and performance, measured by various physical fitness tests. In
addition, and as expected, the training increased fat oxidation rate and
decreased carbohydrate oxidation rate during acute exercise. In this
case vitamin C supplementation for four weeks of interval training did
not affect improvements induced by training on exercise performance
in humans [15].
Thompson et al. from a non-habitual exercise session, evaluated the
effect of two weeks of supplementation with vitamin C on recovery. The
supplemented group received two doses of 200 mg of vitamin C/day, and
two weeks after the start of supplementation, the subjects underwent an
intense and prolonged exercise protocol. The concentration of creatine
kinase and myoglobin was not altered by supplementation. However,
supplementation attenuated muscle pain, benefiting from the recovery
of muscle function [16]. In another study, Thompson et al. investigated
the effect of post-exercise vitamin C supplementation on the recovery
from the performance of an intense, prolonged and unusual workout.
Immediately after the activity, the supplemented group took 200 mg
of vitamin C. This nutritional intervention was repeated again on the
same day and in the morning and evening of the following two days.
The concentration of vitamin C in the supplemented group increased
plasma one hour after the end of the exercise and remained elevated
for three days after exercise. The concentrations of creatine kinase and
myoglobin, however, were not affected by supplementation, and both
the pain and the recovery of muscle function did not differ between
groups [17].
According, Carr et al. the results showed that the intake of this
nutrient within the preset daily recommendations was enough to
saturate the muscle tissue, and not dietary supplementation was
unnecessary for daily replenishment [2].
Studies have recently shown that antioxidant supplementation
can interfere in the cellular signaling induced by exercise in skeletal
muscle fibers. For example, Gomez-Cabrera investigated the effect of
vitamin C on training efficiency in rats and in humans. In the human
study, 14 were trained for 8 week, 5 of the men were supplemented
daily with an oral dose of 1 g vitamin C and the animal study, and
24 male Wistar rats were exercised under for 3 and 6 week. In their
results, the administration of vitamin C significantly (p=0.014)
hampered endurance capacity. The adverse effects of vitamin C may
result from its capacity to reduce the exercise-induced expression
of key transcription factors involved in mitochondrial biogenesis,
prevented the exercise-induced expression of cytochrome C (a marker
of mitochondrial content) and of the antioxidant enzymes superoxide
dismutase and glutathione peroxidase (oral vitamin C). Interestingly,
performance increased resistance to a greater extent in the animals
treated with placebo compared with animals treated with Vitamin C.
Thus, supplementation with high doses of vitamin C to decrease certain
adaptations induced endurance training skeletal muscles [18]. In fact,
high doses of isolated antioxidants should be used with caution in
individuals who are simultaneously engaged in resistance training [19].
Likewise, a high-intensity physical activity and/or duration can be
toxic, because it can generate free radicals from the increased oxygen
consumption by mitochondria. It is believed that this excess of free
radicals can lead to damage on the muscle membranes. However,
Volume 5 Issue 1 1000136
Citation: Quadros L, Brandao I, Longhi R (2016) Ascorbic Acid and Performance: A Review. Vitam Miner 5: 136. doi:10.4172/2376-1318.1000136
the human organism has several endogenous defense mechanisms
to neutralize free radicals and enzymes: superoxide dismutase,
glutathione peroxidase and catalase. On the other hand, regular
physical activity increases the effectiveness of these endogenous
mechanisms, collaborating so that even after strenuous physical
activity, there is no oxidative damage. Nevertheless, it is a common
practice among athletes using extra doses of vitamins, especially C and
E for its antioxidant properties [20]. Its important to highlight that
under normal conditions about 1% of ROS daily escape the control of
the endogenous AOX defenses and contribute to peroxidative damage
to surrounding tissues, and thereby to aging [21].
Vitamin C is also known to regenerate other antioxidants such as
vitamin E, glutathione, back to its reducing condition. Thus, there is
the maintenance of a balanced network antioxidants [22]. Higashida et
al. studied the combined effect of vitamin C (750 mg / kg body weight
/ day) and vitamin E (150 mg kg body weight / day) supplemented
on the adaptive responses training-induced muscle mitochondria
and sensitivity to insulin in rats. Based on the results of this study,
supplementation of vitamin C and E does not have an inhibitory effect
or a promoter effect on the adaptive responses related to mitochondria
and glucose metabolism in skeletal muscle to chronic exercise [23].
Ryan et al. explored the effects of chronic electrical stimulation
combined with supplementation of vitamin C and vitamin E in
homeostasis and muscle function in young rats (7 males by age group
up to 3 months) and old mice (7 males per group aged up 30 months).
The untrained rats were subjected to 80-concentric maximum
eccentric actions per session, three times a week for 4.5 weeks. Vitamin
C supplementation (20 g / kg body weight/day) and vitamin E (30
g kg body weight /day) supplemented started one week before the
first session of electrical stimulation. In summary, the supplemental
vitamin C and E resulted in reduction of the oxidative stress induced
by electrical stimulation and concentric work better in old rats, but not
in young rats [24].
Another study examined the effect of antioxidant vitamins on
the regulation of interleukin-6 expression in the muscles and the
circulation in response to acute exercise before and after high intensity
endurance training. Twenty-one healthy young men were divided into
two groups: VT (vitamin C and E, n=11) and placebo (PL, N=10). In
one of the trials it was conducted acute bike exercise (1 h at 65% of
maximum power), before and after 12 weeks of progressive resistance
exercise training. The effects of the exercise was measured by the
concentration of vitamin C, -tocopherol and interleukin-6 (IL6),
cortisol, protein carbonyls concentrations in plasma, SOD, GPx IL-6
mRNA, malondialdehyde (MDA) concentration in skeletal muscle
biopsies. The results comment that supplementation might attenuate the
acute exercise-induced increase in plasma IL-6, such supplementation
does not seem to further decrease IL-6 levels after 12 wk of vitamin
supplementation combined with endurance training. In conclusion,
the results indicate that, although the supplemental vitamin C and E
can mitigate increases in plasma IL-6 induced by exercise, there is no
clear additive effect when it is combined with resistance training [25].
In their study, Theodorou et al. evaluated a group of men that
received daily oral supplements of vitamin C and vitamin E (n=14)
and placebo (n=14) for 11 weeks (starting 4 weeks before pre-training
exercise testing and continued until the post-training exercise test).
After the baseline test, the subjects performed an eccentric workout
2 times / week for 4 weeks. Before and after chronic eccentric
exercise, subjects were submitted to an acute eccentric exercise
session. Physiological measurements were performed and samples
Vitam Miner
ISSN: 2376-1318 VMS, an open access journal
Page 3 of 4
were collected blood samples and muscle biopsy. The results did not
support any effect of antioxidant supplementation. The complete lack
of any effect on measures of physiological and biochemical results
used, raises questions about the validity of the use of oral antioxidant
supplementation as a redox muscle modulator and redox status in
healthy humans [26].
By reasons above, it is believed that, due to the excess is excreted,
excessive consumption is innocuous. There is no verifiable evidence
that the intake of vitamin C is carcinogenic and teratogenic. Review
on the subject showed that high doses of vitamin C have low toxicity.
Adverse effects were demonstrated with very high doses, above 3 g/ day,
which include diarrhea, gastrointestinal disturbances, increased oxalate
excretion, renal stone formation and increased urinary excretion of
uric acid, pro-oxidative effects and effects abstinence (this effect refers
to the fact that the regular person the system to absorb small part of
high doses available; when the person stops taking the high doses, the
body does not absorb the small amount that becomes ingested) [5].
Conclusions
Despite conflicting data, the importance of vitamin C as an
antioxidant is well established, considering the recommended doses,
usually achieved by feeding. In addition to the capture of free radicals,
cell culture studies demonstrate that vitamin C can alter the expression
of genes involved in the inflammatory response, apoptosis, and cell
differentiation [27].
There is controversy regarding the results associated with vitamin
C and E, two popular antioxidant nutrients. Recent evidence suggests
that the exogenous administration of these antioxidants may be
detrimental to performance. The available studies that used animal
models and humans provide conflicting results on the efficacy
of the supplementation of vitamin C and E at least in part due to
methodological differences in assessing oxidative stress. Based on
contradictory evidence on the effects of increased intake of vitamin C
and / or E on exercise performance and redox homeostasis, a permanent
supplemental doses of vitamin C and / or E cannot be recommended
for physically active [28].
Although studies demonstrate the effectiveness of antioxidants to
alleviate the oxidative stress associated with exercise, much remains to
be clarified. As such, the addition of high doses of vitamin C is not
recommended to endurance athletes undergoing exercise, however
adequate dietary intake of vitamin is necessary for normal muscle
function [2]. Vitamin C may have little or no effect of supplementation;
however, the reduction of their body stores may contribute to increased
oxidative stress [1].
Why is there so much disagreement among studies on the effect
of vitamin C on exercise adaptations? It is believed that the main
reason is the very uniqueness of each study in terms of the type of
exercise (aerobic or anaerobic), species (rat or human), age (young
or old), tissue (blood or muscle), oxidative biomarker and training
of endpoints examined. Other factors that could explain the diversity
of results include nutrition, subject, exercise and characteristics of
experimental error arising from the complexity of the techniques used
in the analysis. Finally, the lack of consensus may be partially explained
by the biological variability [28].
Based on the conflicting evidence on the effects of increased
intake of vitamin C on exercise performance and homeostasis, a
permanent entry of non-physiological doses of vitamin C should not
be recommended for healthy individuals. This should not be confused
with a high intake of fruits and vegetables, which is safe and beneficial [28].
Volume 5 Issue 1 1000136
Citation: Quadros L, Brandao I, Longhi R (2016) Ascorbic Acid and Performance: A Review. Vitam Miner 5: 136. doi:10.4172/2376-1318.1000136
Thus, we see the importance of proper and regular intake of
vitamin C in the diet, but more research is needed to clarify whether
supplementation of this nutrient actually carries on optimizing
performance.
Conflict of Interest
The authors declare no conflict of interest.
Acknowledgments/Grant Support
This study was supported by Universidade Federal do Rio Grande do Sul
(UFRGS) and Universidade Federal do Sergipe (UFS).
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